Courtesy: Dr T Vail, Ashok Shyam TV, Ortho 1?? Evaluation of Labral Pathology and Femoroacetabular Impingement Patient Counseling and Expectations When evaluating patients with: Labral tears Femoroacetabular impingement Key counseling points include: Recovery Timeline Simple labral debridement: Recovery approximately 6 weeks. Extensive impingement correction (cam/pincer correction, labral repair): Recovery 4 to 6 months. Recovery after […]
-Joint Reconstruction
Cementless THR
Courtesy: Dr D Padgett, Ashok Shyam TV, Ortho Limitations of Cemented Fixation Cement fatigue fractures may: Lead to implant loosening Contribute to particle-induced osteolysis Certain patient groups historically performed poorly with cemented fixation: Heavy, highly active males Ideal goal: Direct bone–implant fixation Avoidance of an intermediary cement layer Elimination of a second mechanical interface Biologic […]
Current Trends in Hemi Arthroplasty
Courtesy: Dr Suryanaraya, Ashok Shyam TV, Ortho Hemiarthroplasty vs Total Hip Arthroplasty in the Elderly Ongoing debate in displaced femoral neck fractures: Internal fixation vs hemiarthroplasty vs THA. Considerations: Functional outcome Morbidity and mortality Revision risk Historical Failures of Early Hemiarthroplasty Primary Causes of Early Failure Metallurgical failure Fixation failure Cartilage degeneration over time Design-Related […]
Hip-Alternate Bearing Ceramic
Courtesy: Dr C Ranawat, Ashok Shyam TV, Ortho
Osteolysis in TKR
Courtesy: Dr Ranawat, Ashok Shyam TV, Ortho Background Osteolysis remains a significant long-term complication in total knee arthroplasty (TKA). Strongly associated with: Polyethylene wear debris Modular implant designs Historically uncommon in: Fixed-bearing, monoblock all-polyethylene tibial components. Historical Perspective All-Polyethylene Fixed-Bearing Knees Single-unit tibial component. Long-term data (up to 20+ years): Minimal to no osteolysis reported. […]
Arthrofibrosis
Courtesy: Dr C Ranawat, Ashok Shyam TV, Ortho Introduction Arthrofibrosis is an uncommon but frustrating complication after total knee arthroplasty (TKA). Incidence: < 2% following primary TKA. Defined as: Functional impairment with restricted knee motion. Important distinction: Not all stiff knees are arthrofibrotic. Definition of a Stiff Knee Knee flexion < 75° generally considered stiff. […]
Advances & Techniques in Joint Replacement Surgery
Courtesy: Dr C Ranawat, Ashok Shyam TV, Ortho Case 1: Young, Active Patient with Varus & Flexion Deformity Patient Profile Age: 56 years Weight: 250 lbs Long-standing post-traumatic deformity 15° varus + 15° flexion contracture Previously active tennis player Key Considerations Young, high-demand patient. Long life expectancy ? risk of polyethylene wear. Need durable fixation. […]
Functional Alignment of Knee
Courtesy: Dr Eugene E K, Ashok Shyam, Ortho TV Functional Alignment in Knee Replacement Surgery Introduction Alignment strategies in total knee replacement have evolved significantly over the years. Many surgeons initially adopted mechanical alignment, which has been the traditional and widely practiced method for several decades. Over time, alternative approaches such as kinematic alignment and […]
Dual Mobility Concepts, Complications- THA
Courtesy: Dr. Krishna Kiran, Dr Ashok Shyam, Ortho TV Introduction Dual mobility systems are used in total hip replacement to reduce the risk of hip dislocation. They should not be considered a solution for poorly performed surgery. Proper surgical technique and accurate component positioning remain essential for stability. Understanding Hip Stability in Arthroplasty The native […]
Bilateral THR in Single Setting: Where we Stand
Courtesy: Dr Rajesh Malhotra, Dr Ashok Shyam, Ortho TV Overview Simultaneous bilateral total hip replacement refers to replacing both hip joints during the same surgical session. This approach is increasingly practiced in carefully selected patients with disease affecting both hips. Improvements in anesthesia, surgical techniques, and perioperative care have contributed to the growing acceptance of […]
Spino Pelvic Mobility in THA
Courtesy: Dr Anil Oommen, Dr Ashok Shyam, Ortho TV Overview Spinopelvic mobility has gained increasing attention in recent years in the field of total hip arthroplasty. Many cases of postoperative dislocation are now understood to be related to overlooked factors involving the interaction between the spine and the pelvis. Understanding this relationship is important for […]
Causes of Failure in Hip Arthroplasty
Courtesy: Dr Harish Bhende, Dr Ashok Shyam, Ortho TV Introduction Total hip arthroplasty became widely successful after the development of modern hip replacement designs that combined metal components with polyethylene bearings. Early results were highly encouraging, and the procedure was widely considered one of the most successful operations in orthopaedic surgery. However, within about a […]
Hip Arthroplasty in Fracture Neck of Femur
Courtesy: Dr Harish Bhende, Dr Ashok Shyam, Ortho TV Overview Intracapsular fractures of the femoral neck are common in elderly individuals. Management options include internal fixation or joint replacement. When joint replacement is chosen, two main procedures are considered: Hemiarthroplasty Total hip arthroplasty Clinical studies in patients older than sixty years with displaced femoral neck […]
Complex Primary THA
Courtesy: Dr Amar Ranawat, Dr Ashok Shyam, Ortho TV Introduction Complex hip reconstruction may be required in conditions such as acetabular protrusion, acetabular fractures, post traumatic arthritis, and failed fixation around the hip. These procedures are technically demanding and require careful planning, adequate exposure, and appropriate implant selection. Surgeons must be prepared to address difficulties […]
Getting the Primary Arthroplasty Right
Courtesy: Dr Bill Walter, Dr Ashok Shyam, Ortho TV